Abstract 2050: Preclinical characterization of PRO1106, a novel and promising SLITRK6-directed sesutecan ADC

Abstract SLITRK6 is a type I transmembrane member of the SLITRK family of proteins and is highly expressed in certain epithelial tumors including urothelial, lung, breast cancer and glioblastoma, with minimal-to-low expression in normal tissues. Recent studies with a vedotin-based SLITRK6-directed ADC, AGS15E, have offered clinical proof-of-concept of harnessing this target with the ADC modality for addressing high unmet need at least in bladder cancer. PRO1106 is comprised of a proprietary humanized SLITRK6-targeting IgG1 (dubbed as “mAb”) and the proprietary topoisomerase 1 inhibitor-based linker-drug, sesutecan. Sesutecan previously demonstrated promising characteristics in preclinical studies with multiple targets and conferred an encouraging benefit:risk profile in the clinic with a FRα-directed ADC (rinatabart sesutecan). PRO1106 and the parent mAb exhibited strong binding (with low nanomolar affinity) to recombinant human or cynomolgus monkey SLITRK6 on bio-layer interferometry. No binding was observed with human SLITRK1 or SLITRK4 or in additional negative-binding assays. Potent cellular binding (with sub-nanomolar EC50) was also observed for the parent mAb and ADC with bladder, head and neck, and brain cancer cell lines as well as SLITRK6-overexpressing 293F cells. Target-binding was superior to sirtratumab (the parent antibody in AGS15E) and the binding epitope appeared to be distinct from that of sirtratumab in cross-block studies. PRO1106 displayed rapid internalization and elicited robust cytotoxicity (IC50 in the sub-nanomolar to low nanomolar range) in SLITRK6-expressing tumor cells but not target-negative cells. PRO1106 produced strong tumor growth inhibition in multiple cell-derived xenograft (CDX) models in mice representing bladder cancer and esophageal squamous cell carcinoma. PRO1106 showed a stable PK with much higher exposure compared to an in-house synthesized analog of AGS15E in rats. In an exploratory PK study in cynomolgus monkeys, PRO1106 at 5 mg/kg exhibited extended PK with minimal release of exatecan in circulation and with no apparent toxicity observed. In summary, PRO1106 is an ADC built on a clinically validated linker-drug directed at a clinically validated target, with promising data in preclinical pharmacology studies. As SLITRK6 expression in skin is negligible, PRO1106 may offer an exciting new option for patients with bladder cancer where the current standard-of-care ADC therapy (enfortumab vedotin) confers significant skin-related toxicity burden as well as for patients with additional cancer types. Citation Format: Wanwan Shen, Haotian Lu, Yang Xiao, Xuan Qiu, Haidong Liu, Lei Wang, Zhu Chen. Preclinical characterization of PRO1106, a novel and promising SLITRK6-directed sesutecan ADC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2050.